Sentinel systems are needed for long term adverse drug reactions

doi:10.1136/bmj.330.7485.255-c

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Torbjörn Callréus (torbjorncallreus@hotmail.com), research fellow in pharmacoepidemiology

Institute of Public Health, IPH Research Unit of Clinical Pharmacology, University of Southern Denmark, Winslowparken 19, 3rd floor, DK-5000 Odense C, Denmark

EDITOR—In the wake of the withdrawal of rofecoxib, the limitation of the current system of pharmacovigilance is once again under discussion. With the system's focus on spontaneous reports, unexpected and rare reactions occurring shortly after exposure are usually detected with reasonable sensitivity. However, adverse effects are not readily identified if they occur after long time exposure or manifest themselves as an increase …